NPI | 1386326601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4015649) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11025899) |
Enumeration Date | 2023-08-04 |
Last Update Date | 2024-02-19 |